辛伐他汀联合应用氨氯地平和替米沙坦对高血压病患者的降压作用及逆转高血压左室肥厚的效果  

Effects of simvastatin plus amlodipine and telmisartan in treatment of hypertension and left ventricular hypertrophy

作　　者：赵连友[1] 艾永飞[1] 田刚[2] 何争[3] 姜馨[4] 林可[1] 黄金燕[1] 

机构地区：[1]第四军医大学附属唐都医院心内科,陕西西安710038 [2]西安交通大学第一附属医院心内科,陕西西安710061 [3]第四军医大学附属西京医院心内科,陕西西安710032 [4]陕西省人民医院老年心血管内科,陕西西安710068

出　　处：《心脏杂志》2010年第4期537-540,共4页Chinese Heart Journal

基　　金：国家十一五科技支撑计划子课题资助项目(2006BAI01A03)

摘　　要：目的:比较氨氯地平联合应用替米沙坦(氨+替组)及氨氯地平和替米沙坦联合应用辛伐他汀(氨+替+辛组)对高血压病患者血压及左室肥厚(LVH)的影响,探讨辛伐他汀逆转高血压病LVH的效果。方法:将确诊的79例伴有LVH的高血压病患者随机分配到氨+替组(59例)和氨+替+辛组(20例)。治疗18个月后,观察两组患者心脏形态学、心脏功能及血压水平的变化。结果:①氨+替组及氨+替+辛组高血压病患者经过治疗后,收缩压(SBP)、舒张压(DBP)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室质量(LVM)、左室质量指数(LVMI)与治疗前比较,均有显著性降低(均P<0.01)。②左室舒张早期二尖瓣血流峰速度(E)及晚期血流峰速度(A)比值(E/A)及左室射血分数(LVEF)值与治疗前比较有显著性增高(P<0.01)。③氨+替组和氨+替+辛组两组治疗后SBP、DBP差别无显著性差异,但两组间的IVST、LVPWT、LVM、LVMI的改变比较均有显著差异(P<0.05),氨+替+辛组对其降低作用的效果更明显。结论:氨+替+辛组有更强的降压、逆转LVH及改善心功能的作用,提示辛伐他汀具有逆转高血压LVH及协同保护心脏的效果。AIM： To compare the effect of amlodipine plus telmisartan and simvastatin plus amlodipine and telmisartan on blood pressure in patients with hypertension and left ventricular hypertrophy （LVH） and to explore the effect of simvastatin on LVH. METHODS： Seventy-nine cases of diagnosed LVH were randomly assigned to amlodipine＋amiloride group （59 cases） and amlodipine＋telmisartan＋simvastatin group （20 cases）. Eighteen months after treatment, cardiac morphology and function and blood pressure changes were observed in patients. RESULTS： After treatment, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, interventricular septal thickness （IVST）, left ventricular mass （LVM） and left ventricular mass index （LVMI） significantly decreased in both amlodipine＋telmisartan group and amlodipine＋telmisartan＋simvastatin group （P〈0.01）. E/A ratio and EF values were significantly improved （P〈0.01）. After treatment, no significant difference was observed in SBP and DBP between groups （P〉0.05）. A significant difference was found in IVST, LVPWT, LVM and LVMI （P〈0.05） between groups and the effect of amlodipine＋telmisartan＋simvastatin was more obvious. CONCLUSION： Compared with amlodipine plus telmisartan, combined administration of amlodipine＋telmisartan＋simvastatin is more effective in treating hypertension and reversing LVH, suggesting that simvastatin has the synergistic effect of reversing LVH and conferring cardiac protection.

关 键 词：高血压 原发性 左心室肥厚 氨氯地平 替米沙坦 辛伐他汀 

分 类 号：R972.4[医药卫生—药品]